CHALICE (Children's Head injury ALgorithm for the prediction of Important Clinical Events) Rule
This decision tool is intended to help determine whether a CT scan is needed to evaluate a child's head injury.
***History***
<-- Witnessed Loss of Consciousness > 5 minutes
<-- Amnesia > 5 minutes (retrograde or antegrade)
<-- Abnormal drowsiness (Abnormal ~ exceeds drowsiness expected by the examining doctor)
<-- 3 or more vomiting episodes after head injury
<-- Any suspicion of Non-Accidental Injury (NAI)
<-- Seizure after head injury (and no previous history of epilepsy)
***Examination***
<-- GCS <14 (or GCS <15 if <1 year old) [link url="//www.medicaltext.org/neurological/gcs/" memo="Glasgow Coma Scale"]
<-- Suspicion of penetrating or depressed skull injury, or tense fontanelle
<-- Signs of basal skull fracture (Blood or CSF from ear or nose, panda eyes, Battle's sign, hemotympanum, facial crepitus, or serious facial injury)
<-- Positive focal neurologic sign (Any focal neurologic sign - motor, sensory, coordination, or reflex abnormality)
<-- Bruise, swelling or laceration >5 cm (if <1 year old)
***Mechanism***
<-- High‐speed road traffic accident as pedestrian, cyclist or occupant (High-speed: >40 mph or 64 km/h)
<-- Fall of >3 meters in height
<-- High‐speed injury from a projectile or an object

Score --> resultscore=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)+(Q10)+(Q11)+(Q12)+(Q13)+(Q14)
Interpretation --> resultscore2=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)+(Q10)+(Q11)+(Q12)+(Q13)+(Q14);score2>0?'CT scan is recommended due to risk of intracranial pathology':'Low risk of intracranial pathology'
display/hide references
reference: #1 Dunning J, Daly JP, Lomas JP, Lecky F, Batchelor J, Mackway-Jones K; Children's head injury algorithm for the prediction of important clinical events study group. Derivation of the children's head injury algorithm for the prediction of important clinical events decision rule for head injury in children. Arch Dis Child. 2006 Nov;91(11):885-91.

Result - Copy and paste this output: